Abstract
Introduction. Microsatellite instability is historically closely associated with the development of oncological processes. Early diagnosis of microsatellite instability as a marker for premalignancy, including in the case of endometrial hyperplasia (EH), which is recognized as a premalignancy lesion, is of interest. Identification of the mutational profile characteristic of malignant tumors in benign disease makes it possible to improve prognostic models and therapeutic tactics. Aim. Determination of clinical and anamnestic features of patients with EH and endometrioid adenocarcinoma in a comparative aspect, as well as structural features of microsatellite instability in the endometrium in patients with this pathology. Materials and methods. The study involved 120 women who were divided into 4 groups: group I – EH patients without atypia (n = 30); group II – patients with atypical EH (n = 30); group III – patients with endometrioid adenocarcinoma (n = 30); group IV – healthy women without somatic and gynecological pathology (n = 30). A comparative morphological study of endometrial samples was performed and levels of MLH-1, MSH-2, MSH-6 and PMS-2 expression were assessed. Results. It was revealed that most EH patients without atypia, patients with atypical EH, endometrioid adenocarcinoma complained of abnormal uterine bleeding; the history of patients of these groups is characterized by the presence of cardiovascular and endocrine diseases, and the gynecological history is characterized by the presence of uterine fibroids, benign breast diseases and pelvic inflammatory diseases. There was found a decrease in the MLH-1, PMS-2, MSH-2 and MSH-6 expression in endometrial biopsies of women with EH. Conclusion. Decreased expression of MLH-1, PMS-2, MSH-2 and MSH-6 in endometrial biopsies can probably be considered as a predictor of premalignant transformation, which requires further study in order to develop a program of malignancy risk assessment.
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